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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 114367
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.114367
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.114367
Induction therapy in kidney transplant recipients: A consensus statement of Indian Society of Organ Transplantation
Vivek B Kute, Subho Banerjee, Divyesh P Engineer, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, Gujarat, India
Manish Ramesh Balwani, Amit Pasari, Department of Nephrology, Saraswati Kidney Care Center, Nagpur 440015, Maharashtra, India
Manish Ramesh Balwani, Amit Pasari, Pranjal Kashiv, Department of Nephrology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha 442005, Mahārāshtra, India
Jigar B Shrimali, Department of Nephrology, Renus Kidney Hospital, Ahmedabad 380015, Gujarāt, India
Vijay Kher, Department of Nephrology and Kidney Transplantation, Epitome Kidney Urology Institute and Lions Hospital, New Delhi 110016, Delhi, India
Mohan Punabhai Patel, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr HL Trivedi Institute of Transplantation Sciences, Nashik 422006, Mahārāshtra, India
Deodatta Chafekar, Dr V N Pawar Medical College, Director Supreme Kidney Care, Nashik 422005, Mahārāshtra, India
Swarnalata Guditi, Department of Nephrology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Pratik Das, Department of Nephrology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata 700099, West Bengal, India
Gireesh Mathihally Siddaiah, Department of Nephrology, Ramaiah Medical College, Bangalore 560054, Karnātaka, India
Suraj Mohan Godara, Department of Nephrology and Clinical Transplantation, Mahatma Gandhi Medical College and Hospital, Jaipur 302001, Rājasthān, India
Vinant Bhargava, Anurag Gupta, Department of Nephrology, Sir Ganga Ram Hospital New Delhi, New Delhi 110001, New Delhi, India
Vishal Ramteke, Nishant Deshpande, Department of Nephrology, Max Super Speciality Hospital, Nagpur 440030, Mahārāshtra, India
Priyanka Tolani, Department of Internal Medicine, Jawaharlal Nehru Medical College, Wardha 442001, Mahārāshtra, India
Narayan Prasad, Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Radhika Krishna Patil, Department of Pathology, Shri Balaji Kidney Care, Hyderabad 500005, Telangāna, India
Ravi Mohanka, Department of Liver Transplant and HPB Surgery, Sir HN Reliance Foundation Hospital, Maharashtra 400004, India
Sandeep Mahajan, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Sourabh Sharma, Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, Delhi, India
Dhananjai Agarwal, Department of Nephrology, SMS Medical College, Jaipur 302001, Rājasthān, India
Arpita Lahiri, Department of Nephrology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata 700020, India
Dinesh Khullar, Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Saket 110017, New Delhi, India
Aneesh Srivastava, Department of Urology and Renal Transplant, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Co-corresponding authors: Manish Ramesh Balwani and Pranjal Kashiv.
Author contributions: Balwani MR and Kashiv P served as co-corresponding authors as both played equally critical and complementary roles in conceptualizing, supervising, coordinating, and finalizing the study. Balwani MR oversaw the scientific design, multicentre coordination, and methodological integrity of the project, while Kashiv P coordinated national data acquisition, validation, manuscript drafting, and correspondence with the editorial office. Both contributed equally to data interpretation, revisions, and final approval, justifying co-corresponding authorship; Kute VB and Balwani MR conceptualized and designed the research; Shrimali JB, Pasari A, Kher V, Patel MP, Chafekar D, Guditi S, Das P, Gireesh MS, Godara SM, Bhargava V, Gupta A, Ramteke VV, Deshpande NS, Tolani P, Khullar D, Prasad N, Patil RK, Mohanka R, Mahajan S, Sharma S, Banerjee S, Engineer DP, Agarwal D, Kashiv P, Lahiri A, and Srivastava A performed the research through survey design, literature review, consensus panel participation, and expert clinical input; Tolani P and Kashiv P analyzed and collated data; Kute VB, Balwani MR, Pasari A, and Shrimali JB wrote the initial draft of the manuscript; Kher V, Khullar D, Mahajan S, Prasad N, and Mohanka R critically revised the manuscript for scientific accuracy and national representation; all authors read and approved the final version of the paper.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manish Ramesh Balwani, DM, MD, Professor, Department of Nephrology, Saraswati Kidney Care Center, 13, Jaitala Road, Near Jaiprakash Nagar Metro Station, New Sneh Nagar, Nagpur 440015, Maharashtra, India.
Received: September 17, 2025
Revised: September 27, 2025
Accepted: November 26, 2025
Published online: March 18, 2026
Processing time: 119 Days and 16.9 Hours
Revised: September 27, 2025
Accepted: November 26, 2025
Published online: March 18, 2026
Processing time: 119 Days and 16.9 Hours
Core Tip
Core Tip: Kidney transplantation is the most common solid organ transplantation in India, yet induction immunosuppression practices vary widely across centers. The Indian Society of Organ Transplantation (ISOT) conducted a nationwide survey and identified significant heterogeneity in induction therapy choice, dose, and duration. Through a structured Delphi consensus, ISOT developed 16 statements to guide practice. Rabbit anti-thymocyte globulin (rATG) remains the preferred induction for high immunological risk and deceased donor recipients, while interleukin-2 receptor anatagonists or low-dose rATG is suitable for low-risk cases. Rituximab is recommended for ABO-incompatible transplants. These India-specific guidelines provide a standardized framework to optimize patient outcomes and rationalize induction therapy.